Advances in total knee replacement

3D-printed cementless components in combination with robotic surgery

If you have arthritis in your knees, you know how painful it can be. If the arthritis is bad enough, you may no longer be able to run or climb stairs. You may have constant pain and can’t sleep at night. Your quality of life can suffer.

This kind of knee pain happens when the cartilage that cushions the knee is damaged. For most people, it’s caused by natural wear and tear over time – especially for those who are overweight or who play sports. When the cartilage wears away, the knee is bone-on-bone. There is no longer anything that keeps the bones from rubbing against each other. You don’t just have pain – your knee can “go out” and you can easily fall. You may need a knee replacement.

Most knee replacements in the U.S. are offered for people ages 60 or older. One reason for this is that historically a knee replacement would have only lasted 10-20 years. That is because most knee replacements had used bone cement that might have broken down over time. When the cement wears out or loosens, a second surgery called a “knee revision” is needed to repair the joint. A new procedure, called cementless knee replacement, can help the artificial knee last longer and possibly avoid a knee revision surgery.

“The cement we use with traditional total knee replacement is similar to the same material a dentist uses to fill cavities,” said Sameer Badarudeen, M.D., Orthopaedic Surgeon with Med Center Health Orthopaedics & Sports Medicine. “So just like a cavity’s filling can come loose, the hardware can come loose.” At The Medical Center, Dr. Badarudeen uses 3D-printed cementless total-knee replacements in his total knee surgeries.

Cementless knee surgery uses the body’s natural healing ability. The new knee prosthetic has a specially-designed 3D-printed surface that helps bone grow over it, holding it in place. With bone instead of cement, the new joint may last longer. Bone growth works best with patients who are younger – and that means you may no longer have to wait until you are over 60 to have a knee replacement. Today, knee replacement surgeries at The Medical Center can be for anyone over the age of 40. However, cementless knee replacement isn’t for everyone. It takes strong, healthy bone to hold the implant in place. So, if you have poor bones due to a condition such as osteoporosis, traditional cemented knee replacement is recommended. Research has shown that in patients who are obese, cementless knee replacements are a better option than cemented because it lowers the risk of parts coming loose over time.

“Cementless knee replacement is a good option for people who are having first-time total knee replacement regardless of body weight,” said Dr. Badarudeen, “Bone quality is the primary requirement. In order to have a very successful outcome, you need to have very good quality bone. At The Medical Center, we have been doing cementless knee replacement for about a year with a high success rate. We haven’t had a single failure where the hardware has come loose.” Total knee replacement is done in combination with Mako™ robotic-arm-assisted surgery technology for greater accuracy and better outcomes.

Anybody who has severe wear and tear osteoarthritis in their knee and has had unsuccessful regular non-surgical treatment such as exercise treatment, physical therapy, or injections can be a candidate for knee replacement surgery. If you are experiencing quality of life issues due to constant pain in your knees, talk to your doctor about knee replacement. For an appointment with Med Center Health Orthopaedics & Sports Medicine, call 270-780-2750. Learn more at MedCenterHealth.org/ortho.